Role Of Soluble ST2 In The Diagnosis Of Heart Failure

ObjectivesThis study was desined to observe the change of the serum soluble ST2 (sST2) levels in patients with heart failure(HF), investigating the role of sST2 in evaluation of cardiac function and diagnosis of heart failure.MethodsThis study included 129 patients with heart failure (HF) hospitalized in the cardiology department of the Second Xiangya Hospital, Central South University between Nov,2009 and Mar,2010. Patients were divided into three groups according to NYHA heart function classification criterion:NYHA ClassⅡgroup(n=66), NYHA ClassⅢgroup(n=32) and NYHA ClassⅣgroup(n=31). Thirty five normal subjects were recuited as control group. All the subjects were examined by UCG at admission. The concentration of NT-proBNP was measured by cobas e411 detection instrument (Roche company) and the concentration of sST2 levels were assayed with enzyme-linked immunosorbent assays.ResultsThe levels of serum sST2 were significantly higher in patients with NYHA functional classⅢ-Ⅳ[1.84(0.93-3.19) ng/ml] than in patients with NYHA functional class II [0.94(0.83-1.30)ng/ml, p<0.001] and in controls [0.77(0.69-1.92)ng/ml, p<0.001]. Patients with NYHA functional classⅡtended to have higher sST2 levels than controls, but the difference did not reach statistical significance (P=0.191). Serum sST2 levels were correlated positively with amino terminal B-type natriuretic peptide (NT-proBNP) (rs=0.352,P<0.001), NYHA functional class(rs =0.456, P＜0.001), and left ventricular diastolic volume(rs=0.287, P<0.001), and negatively with left ventricular ejection fraction(LVEF)(rs =-0.288, P=0.016). Receiver-operator characteristic curves(ROC) for diagnosis of heart failure demonstrated an AUC of 0.775 for sST2 (95% confidence interval [CI]:0.68 to 0.87; p<0.001), an AUC of 0.889 for NT-proBNP [95%CI:0.83 to 0.94;P<0.001], an AUC of 0.926 for combination of both biomarkers [95%CI:0.88 to 0.98;P<0.001]。Conclusions1. Serum sST2 was significantly increased in patients with heart failure.2. Serum sST2 levels were correlated positively with amino terminal B-type natriuretic peptide(NT-proBNP) and negatively with left ventricular ejection fraction3. sST2 may be a new biomarker of heart failure and can provide additive value to NT-proBNP levels in the diagnosis of heart failure.